CASE STUDY: TREATING OPERATIONAL DYSFUNCTION

"First Responders" Stabilize Victim
Of Acute Billing Failure
   
An Obstetrics and Gynecology practice with offices in the Northeast had been operating successfully for years and enjoyed a high level of regard among its patients. With four full partners, six midwives and seven doctors, there was always a whirlwind of patient activity, but a whirlwind of problems gathering strength in the back office almost brought the practice to its knees.  

After two months without issuing a single claim, a call for  help goes out on the morning of Christmas Eve.

Unbeknownst to the senior principals, wires were badly crossed among members of the staff responsible for critical office functions related to billing, scheduling and general management. The roles and duties they were to perform were ill-defined, and while they scrambled each day to get it all done, all of it was not getting done well. Compounding this, no one was able - or empowered - to administer a new practice management system in order to properly bill, process claims and manage scheduling. The revenue cycle was in a complete state of seizure, and to cover for it, expenses were being met by exhausting a $400,000 credit line.  

VantagePoint deploys an on-site crisis management team...

Responding immediately to the holiday phone call, VantagePoint installed two experts in financial management and operations to work directly with staff to restore revenue, take command of the new software and correct workflow problems. Working together, a two-month backlog of unsubmitted claims were completed within the first several weeks. Consultation and coaching was conducted in the human resources area to better define procedures and improve communication and interaction among staff and with partners. A comprehensive review of finances was undertaken, leading to a critical evaluation of equipment acquisitions, vendor contracts and other expenses.

...and a top-down correction proceeds on all fronts.

Within two months, $500,000 was restored from the processing of dormant claims and the revenue cycle was on track, and with expenses reined in and held closely in check, the credit line was quickly repaid. The staff now operates with a clear grasp of proper billing procedures, credentialing and use of the practice management system. Staff members, their roles clearly defined, now carry out their duties effectively and in a spirit of cooperation.

THE VANTAGEPOINT ADVANTAGE
 
To assist clients in crisis, we are able to place members of our own staff directly within a practice, providing training and management support in all relevant areas, until issues are sustainably resolved.

WHO WE ARE
 
  VantagePoint is a team of industry experts who are dedicated to improving the business of medicine. With vast experience in executive management, operations, finance, clinical services and compliance, we deliver unparalleled, measurable and quantifiable results for our clients.

 

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VantagePoint is an informational news article series produced by VantagePoint Healthcare Advisors.
With each edition we strive to bring vital information
to the healthcare industry on topics of policy, finance, compliance and business management.

 

Visit our website or call 203-288-6860 and learn more about how our team of industry experts can benefit your practice or organization.

 


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